Table 2 Facilitators and barriers to infant feeding options
Facilitators | Barriers | ||
|---|---|---|---|
Direct breast- feeding | Frequently mentioned | ● Maternal nutrition (i.e., diverse diet and good nutrition) ● Lactation support ● Position of infant on breast | ● Perceived insufficient milk production ● Poor latch to nipple ● Infant falling asleep ● Breast or nipple pain |
Less frequently mentioned | ● Supportive home environment ● Breast milk being free/available ● Massaging breasts to stimulate milk production ● Proximity of mother to infant | ● Infant vomiting or coughing ● Lack of support from healthcare providers (e.g., observations of feeding) ● Maternal stress | |
Expressed breast milk | Frequently mentioned | ● Maternal nutrition (i.e., diverse diet and good nutrition) ● Lactation support, including physical support ● Private space | ● Perceived insufficient milk production ● Breast or nipple pain ● Maternal stress ● Problems expressing by hand |
Less frequently mentioned | ● Massaging breasts to stimulate milk production ● Equipment (e.g., having pumps or cups to feed) ● Observing other mothers express | ● Lack of equipment in facility (e.g., cups) ● Limited staff to help caregivers ● Lack of hygiene standards for equipment | |
Donor human milk (DHM) | Frequently mentioned | ● Community education, awareness, and outreach ● Sufficient number of donor mothers ● Trained staff | ● General lack of knowledge of DHM and HMBs ● Concerns around milk safety and disease transmission ● Concerns around equipment cleanliness ● Concerns around mismatch of health, social, and religious backgrounds of donor mother and recipient infant/family |
Less frequently mentioned | ● Accessibility and location of human milk banks (HMBs) for donation and distribution ● Peer support among donating mothers | ● Lack of support from family and community for mothers to donate and feed breast milk ● Lack of refrigeration at the facility and home | |
Infant formula | Frequently mentioned | ● Education on how to mix and feed infant formula ● Someone else prepares infant formula so mother does not have to | ● Cost ● Knowledge/ability to prepare infant formula ● Storage ● Fear of infant illness |
Less frequently mentioned | ● Infant formula provided or donated by HCP, family member, community member or well-wisher | ● Access to clean water ● Confusion around which product to purchase | |